Published: 2021-12-27

Molecular detection and genotyping of Chlamydia trachomatis circulating in women of Western Cameroon: a cross-sectional study

Boris E. D. Gomseu, Rajneesh Dadwal, Jean-De-D. Tamokou, Rakesh Yadav, Wiliane J. T. Marbou, Jules R. Kuiate, Sunil Sethi


Background: In Cameroon, C. trachomatis screening is not routinely practiced, and its epidemiology is still unexplored. The present study aimed to determine the prevalence of C. trachomatis infection, its risk factors and the genotypes circulating in the West Cameroon region.

Methods: A cross-sectional study was carried out amongst patients in five district hospitals in the West region of Cameroon. Endocervical samples were collected from women visiting the hospitals forantenatal, prenuptial and contraception consultations and at least 18 years old, sexually active, and non-menstruating. The molecular detection of C. trachomatis was performed using conventional polymerase chain reaction (PCR) followed by sequencing of the ompA gene.

Results: The prevalence of C. trachomatis infection was determined to be 11.47%. Having sex for the first time between the ages of 15 and 17 (OR=1.683, 95% CI: 1.1-2.5), non-usage of condom (OR=1.622, 95% CI: 1.2-2.1), being single (OR=1.263, 95% CI: 1.0-1.5) and age range 18-30 years (OR=1.426, 95% CI: 1.1-1.8) were risk factors for C. trachomatis infection. Three genotypes of C. trachomatis circulated in West Cameroon viz. D (49%), E (29.4%) and G (21.6%).

Conclusions: This study revealed that, three genotypes; D (dominant), E and G were identified circulating in the population of the study area. This information may be important for controlling the dissemination of C. trachomatis infection in West Cameroon as well as strategizing the therapeutic approach.



Women, West Africa, Chlamydia trachomatis, Endocervical swab, Genotype

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Rowley J, Vander HS, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, Gonorrhoea, trichomonas and syphilis: Global prevalence and incidence estimates, 2016. Bull World Health Organ. 2019;97(8):548-62.

Eggert-Kruse W. Prevalence of Chlamydia trachomatis in subfertile couples. Fertility and Sterility. 2003;80(3):660-3.

World Health Organization. Growing antibiotic resistance forces updates to recommended treatment for sexually transmitted infections. Available at: Accessed on 15 February 2021.

Newman L, Rowley J, Vander Hoorn S, et al. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. Plos One. 2015;10:e0143304.

Sunil S, Amit R, Shubha G, Venkatesan LS, Bagga R. Detection of Chlamydia trachomatis infections by polymerase chain reaction in asymptomatic pregnant women with special reference to the utility of the pooling of urine specimens. Indian J Med Res. 2017;146(7):59.

Adachi K, Nielsen-Saines K, Klausner JD. Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia. Biomed Res Int. 2016;1-21.

Sende P, Abong, T, Garrigue GP. Chlamydia trachomatis: a prevalence study among pregnant and infertile female patients and among men suffering from chronic urethritis. Afr J Sex Transm Dis. 1986;2:72-4.

Kaptue L, Zekeng L, Djoumessi S, Monny-Lobe M, Nichols D, Debuysscher R. HIV and chlamydia infections among prostitutes in Yaounde, Cameroon. Arch Genitourin Med. 1991;67(2):143-5.

Ngandjio A, Clerc M, Fonkoua M, Thonnon J, Njock F, Pouillot R, et al. Screening of Volunteer Students in Yaounde (Cameroon, Central Africa) for Chlamydia trachomatis Infection and Genotyping of Isolated C. trachomatis Strains. J Clin Microb. 2003;41(9):4404-7.

Noatina NB, Kagmeni G, Nimpa MM, Moungui HC, Tarini A, Zhang Y, et al. Prevalence of Trachoma in the Far North Region of Cameroon: Results of a Survey in 27 Health Districts. PLOS Negl Trop Dis. 2013;7(5):e2240.

Ngondé EMC, Nsawir BJ, Nana RD, Thonnon J, Njock F, Pouillot R, et al. Etude séro-epidémiologique de trois infections sexuellement transmissibles (Chlamydia Trachomatis, Hépatite B, Syphilis): cas de l’Hôpital de District de Nkoldongo à Yaoundé. Pan Af Med J. 2016;25.

Sanou SM, Donfack JH, Onohiol J-F, Mbongue G, Watcho P, Fokam J, et al. Prevalence of HIV, HBV and Chlamydia Infections in Cameroonian University Context: Case of the University of Dschang, in the Western Region. IJHSR. 2015;5:265-73.

Fogue P, Djeudong G, Bouting G, Aglago E, Simo G, Lueong S, et al. Molecular characterization of lower vaginal swabs for Human papilloma virus in association with Chlamydia trachomatis infection in Cameroonian Women. J Infect Public Health. 2018;11(3):314-20.

Detailed STD Facts - Chlamydia. Chlamydia – CDC Fact Sheet (Detailed). Available at: Accessed on 22 July 2021.

Ajani TA, Anaedobe CG, Oluwasola TA, Ajani MA, Fayemiwo SA, Bakare RA. Polymerase chain reaction versus enzyme-linked immunosorbent assay in detection of Chlamydia trachomatis infection among gynaecological patients in South-Western Nigeria. Afr J Clin Exper Microb. 2018;9(2):76-83.

Santos C, Teixeira F, Vicente A, Astolfi-Filho S. Detection of Chlamydia trachomatis in endocervical smears of sexually active women in Manaus-AM, Brazil, by PCR. Braz J Infect Dis. 2003;7(2):91-5.

Mazen AO, Wafa IE, Khalid AE. Molecular Detection of Chlamydia trachomatis among Sexual Transmitted Infections patients in Khartoum. Afr J Med Sci. 2018;3.

Margaretha J, Lars F, Hans F. Characterization of Chlamydia trachomatis omp1 Genotypes among Sexually Transmitted Disease Patients in Sweden. J Clin Microbiol. 2001;39:3915-9.

Francis SC, Mthiyane TN, Baisley K, Mchunu SL, Ferguson JB, Smit T, et al. Prevalence of sexually transmitted infections among young people in South Africa: A nested survey in a health and demographic surveillance site. Plos Med. 2018;15:e1002512.

Hokororo A, Kihunrwa A, Hoekstra P, Kalluvya SE, Changalucha JM, Fitzgerald DW, et al. High prevalence of sexually transmitted infections in pregnant adolescent girls in Tanzania: a multi-community cross-sectional study. Sex Transm Infect. 2015;91(7):473-8.

de Borborema-Alfaia APB, de Lima FNS, Filho SA, Borborema-Santos CM. Chlamydia trachomatis infection in a sample of northern Brazilian pregnant women: prevalence and prenatal importance. Brazilian J Infect Dis. 2013;17:545-50.

Niccolai LM. Condom effectiveness for prevention of Chlamydia trachomatis infection. Sex Transm Infect. 2005;81(4):323-5.

Morhason-Bello IO, Ojengbede OA, Oladokun A, Adedokun BO, Ajayi A, Adeyanju AA, et al. The prevalence and outcome of asymptomatic chlamydial infection screening among infertile women attending gynecological clinic in Ibadan, South West Nigeria. Ann Med Health Sci Res. 2014;4(2):253.

Nwankwo E, Magaji N. Prevalence of Chlamydia trachomatis infection among patients attending infertility and sexually transmitted diseases clinic (STD) in Kano, North Western Nigeria. Af Health Sci. 2014;14(3):672.

Yirenya-Tawiah D, Annang TN, Apea-Kubi KA, Lomo G, Mensah D, Akyeh L, et al. Chlamydia trachomatis and Neisseria Gonorrhoeae prevalence among women of reproductive age living in urogenital schistosomiasis endemic area in Ghana. BMC Res Notes. 2014;7(1).

National AIDS Control Committee. National Strategic Plan to fight HIV, AIDS and STIs 2011-2015. Yaoundé, Cameroon. 2010;120.

Batool HR, Leili CT, Fedyeh H, Mahmood JT, Mohammed MN, Mamak S, et al. Effects of Chlamydia trachomatis infection on fertility, a case control study. J Reprod Fertility. 2013;14:67-72.

Mahony JB, Luinstra KE, Sellors JW, Chernesky MA. Comparison of plasmid- and chromosome-based polymerase chain reaction assays for detecting Chlamydia trachomatis nucleic acids. J Clin Microb. 1993;31(7):1753-8.

Chen Y, Chen J, Yang L, Yanming J, Li L, Wenjuan Y, Lifang L, et al. Distribution of Chlamydia trachomatis Genotypes in Infective Diseases of the Female Lower Genital Tract. Med Sci Monitor. 2017;23:4477-81.

Rawre J, Dhawan B, Khanna N, Sreenivas V, Broor S, Chaudhry R, et al. Distribution of Chlamydia trachomatis omp A genotypes in patients attending a sexually transmitted disease outpatient clinic in New Delhi, India. Ind J of Med Res. 2019;149(5):662.

Petrovay F, Balla E, Németh I, Gönczöl É. Genotyping of Chlamydia trachomatis from the endocervical specimens of high-risk women in Hungary. J Med Microb, 2009;58(6):760-4.

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines. MMWR. 2015;64:106.

Taheri Beni B, Motamedi H, Ardakani MR. Genotyping of the prevalent Chlamydia trachomatis strains involved in cervical infections in women in Ahvaz, Iran. J Med Microb. 2011;60(3):396.